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Biomedical subjects

G E Gresham

Publications and source records attributed to G E Gresham.

At least 19 recordsLinked to original sources
PubMed1991

Muscle rehabilitation: its effect on muscular and functional performance of patients with knee osteoarthritis.

Muscle function and functional performance are limited in patients with osteoarthritis (OA). Although aerobic exercise can increase aerobic power and reduce fatigue, it does not appear to improve muscle function. The purpose of this study was to demonstrate the effect of a muscle rehabilitation program on muscle strength, endurance, speed, and function for patients with OA of the knees. Fifteen men (67.6 +/- 6.1 years) with OA of the knees underwent a four-month exercise program, three times per week. Muscle strength, endurance, and speed were 50% less in OA patients than in controls. After rehabilitation, there was a significant increase in strength (35%), endurance (35%), and speed (50%). Deficiencies and improvements in the muscles were greater at longer muscle lengths. Increases in muscle function were associated with decreased dependency (10%), difficulty (30%), and pain (40%). The average increase in all measured parameters was 10% and 25% after two and four months of rehabilitation, respectively. Improvements were sustained for eight months after rehabilitation. The muscle rehabilitation program was designed specifically to improve function; the improved muscle function was translated into improved functional performance.

Aged↗
PubMed1989

More research needed.

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Activities of Daily Living↗
PubMed1989

The stroke rehabilitation outcome study: Part II. Relative merits of the total Barthel index score and a four-item subscore in predicting patient outcomes.

Part I of this series described the background of the study; the characteristics of the patient population; and their functional status before onset of stroke, at rehabilitation admission, at discharge, and at six months after discharge. Results at follow-up showed that patients with higher Barthel index scores living in the community were more likely to be satisfied with life in general, to have more person-to-person contacts, and to be more active in community affairs. Part II describes the utility of two sets of data derived from the admission Barthel index (combinations of independent performance of four basic items of the index vs the total score) in predicting the likely range of Barthel index scores at discharge and functional outcomes at six-month follow-up.

Activities of Daily Living↗
PubMed1988

Factors influencing survival and need for institutionalization following stroke: the Framingham Study.

The distinction between factors that influence survival after stroke and those that increase the likelihood of institutionalization is an important health issue. Estimates of survival and frequency of institutionalization after stroke vary widely, depending on the patient population. A precise picture of variability of outcome from stroke may be obtained from a prospective epidemiologic study. This report uses the Framingham Study population sample of 5,184 men and women, aged 30 to 62 at entry in 1948, who were free of cardiovascular disease. All completed strokes that occurred between 1971 and 1981 were evaluated. Of the 213 patients with completed strokes, 154 survived more than 30 days. Multivariate logistic regression analysis indicated that acute survival was negatively influenced by stroke type, severity of neurologic impairment, and age. For those who survived at least 30 days, independent living was determined by social factors as much as by severity of disability. Being married protected men but not women from institutionalization. Older women, married or not, with moderate to severe residual impairment and minimal education, were at highest risk of institutionalization. In acute stroke, medical factors dominated rates of survival. However, in those who survived, family and social factors had an equal impact in determining final outcome from stroke.

Activities of Daily Living↗
PubMed1988

The stroke rehabilitation outcome study--Part I: General description.

Part I describes the background of the study, the characteristics of the patient population, and their functional status before onset of stroke, at rehabilitation admission, and at discharge, and the outcomes six months after discharge. Results showed that the average age was 69; 40% had right hemiparesis, 43% left, and 17% bilateral deficits. Medical complications during rehabilitation hospitalization were more common in patients who, at follow-up, were either living in a long-term care facility or had died. Average length of medical rehabilitation stay was 37 days, with mean admission and discharge Barthel Index scores of 37 and 66, respectively. Seventy percent of patients were discharged to the community and 68% were in the community six months after discharge. Patients with higher Barthel Index scores at discharge were more likely to be living in the community at follow-up. Patients living in the community at follow-up, with higher Barthel Index scores, were more likely to be satisfied with life in general, have more person-to-person contacts, and be more active in community affairs.

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PubMed1987

Traditional approaches to functional assessment in arthritis.

Both clinical rheumatology and medical rehabilitation have traditional functional assessment approaches to patients with arthritis. Drawing from both, a suggested "universe of function" for rheumatic disease patients is presented. The variables included begin with components of the physical examination and continue to maneuvers performed by the patient, mobility, activities of daily living (ADL), upper extremity function, extended living functions, and global assessment instruments. The development of standardized methodologic techniques is greater for some variables, especially ADL. In all, there is a need for a consensus approach so that aggregate data generated in different studies and programs will be more comparable.

Arthritis, Rheumatoid↗
PubMed1986

The Quadriplegia Index of Function (QIF): sensitivity and reliability demonstrated in a study of thirty quadriplegic patients.

The Quadriplegia Index of Function (QIF) was originally developed by the authors in 1980 because the popular Barthel Index was deemed too insensitive to document the small but significant functional gains made by quadriplegics (tetraplegics) during medical rehabilitation. The QIF has now been tested on a group of 30 complete quadriplegic patients at admission to and discharge from inpatient medical rehabilitation. Resultant scores were compared to those simultaneously obtained by the Barthel Index and the Kenny Self-Care Evaluation. The QIF was found to be more sensitive (46 per cent improvement as opposed to 30 per cent by the Kenny Self Care Evaluation and 20 per cent by the Barthel Index). The QIF was also tested for reliability. Ratings by three different nurses, working independently, were found to be significantly positively correlated for all sub-scores (p less than .001). We conclude that the QIF provides a useful option in choosing a functional assessment instrument for use with quadriplegic patients.

Activities of Daily Living↗
PubMed1982

Rehabilitation of the geriatric patient. Stroke rehabilitation, the rehabilitation team, and the usefulness of functional assessment.

Salient features of rehabilitation in the elderly are illustrated through the case history of a stroke patient. The efforts of the multidisciplinary rehabilitation team and the consideration of alternative settings and levels of care are critical factors in the restoration and preservation of function in the elderly. Systematic functional assessment, using instruments such as the Barthel index, is recommended to document patient outcomes.

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PubMed1982

Hand function in osteoarthritis.

The effect of osteoarthritis (OA) on hand function of 67 institutionalized subjects was evaluated. Osteoarthritis changes were scored using the radiographic criteria of Kellgren and Lawrence. The total number of joints involved and average severity of affected joints were computed and then related to hand functions as measured by: (1) grip strength, and (2) mean times in completing maneuvers of Jebsen's test for hand function. Grip strength was significantly less in those with OA than in those without OA. Performance on the Jebsen maneuvers was less consistent. Compared with published normal values, mean times for the whole sample were longer. However, mean times between those with and without OA were not significantly different. A multiple regression of the effects of average severity rather than number of involved joints that accounts for the greater proportion of variance in the dominant hand. While OA of the hands is positively correlated with reduced function, the resulting disability appears to be relatively benign.

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PubMed1979

Epidemiologic profile of long-term stroke disability: the Framingham study.

One hundred forty-eight long-term stroke survivors and 148 control persons matched for age and sex, from the Framingham Study cohort, were examined for residual functional disability. Prevalence rates for 9 specific types of functional deficit ranged from 15% for institutionalization, to 63% for decreased vocational function in the group of stroke survivors. The comparable rates in the control group were significantly lower. Cardiovascular comorbidity was greater in stroke survivors than in controls. Removal of its apparent effects on function decreased the magnitude, but not the overall pattern, of documented disability in both groups. The most severe disabilities, institutionalization, dependence in mobility, and dependence in self-care, were the least prevalent. The more frequently documented types of functional deficit were those in which psychosocial and environmental factors are significant determinants.

Activities of Daily Living↗
PubMed1975

Residual disability in survivors of stroke--the Framingham study.

Of 123 survivors of documented completed stroke from the Framingham Cohort, 119 received objective evaluations of functional status along with an equal number of controls matched for age and sex. Of the stroke survivors, 16 per cent were institutionalized, 31 per cent dependent in self-care, and 20 per cent dependent in mobility. In addition, 71 per cent had decreased vocational function, and 62 percent decreased socialization outside the home. Each of these frequencies was significantly greater than the corresponding rate in the control group.

Activities of Daily Living↗
PubMed1975

Osteoarthritis in knees of aged persons. Relationship between roentgenographic and clinical manifestations.

One hundred five (70%) of the knee joints of 75 elderly people showed roentgenographic changes of osteoarthritis (OA); occurrence rates for each of ten clinical manifestations ranged from 7% to 76%. Clinical manifestations were more common in knees with OA by x-ray film than in those without. Crepitus, decreased range of motion, pain, bony enlargement, and instability were simultaneously common in the roentgenographically abnormal knees and significantly less frequent in normal knees. Overall functional disability was verified in 22% of the knees with changes on x-ray film. The findings suggest a more positive and specific pattern of correlation between clinical and roentgenographic findings than has generally been believed. Nevertheless, the frequency of dissociation confirms the importance of making therapeutic decisions according to each patient's individual situation.

Age Factors↗
PubMed1975

The efficacy of antimalarials in systemic lupus erythematosus.

Of 209 patients who fulfilled the A.R.A. criteria for the diagnosis of systemic lupus erythematosus, 43 were selected for study because each had been treated for at least two years with antimalarials, but had not received antimalarials for at least one subsequent year. In each instance, the antimalarial was discontinued solely because of the development of retinopathy. Each year on antimalarials was matched with a subsequent year off antimalarials for each patient. The year immediately following diagnosis and years of pregnancy were excluded. Paired-t test analysis of matched years revealed that general symptoms (fever, fatigue, weight loss) were less common during years on 500 mg chloroquine daily than during years off the drug (p less than 0.05). Skin manifestations were also less frequent during the years on 500 mg chloroquine daily than during the years off (p less than 0.05). No significant steroid sparing effect was found. However, a greater incidence of flare-ups during the matched years off the drug was statistically significant.

Adolescent↗